Outcomes Of Surgical Treatment In Inverted Papilloma Of Nose And Paranasal Sinuses - A Retrospective Study

Abstract

Background: Inverted papilloma is a rare benign tumor of the nasal cavity and paranasal sinuses arising from the Schneiderian membrane. It exhibits local aggressiveness, high recurrence rates, and potential for malignant transformation. The Krouse classification is commonly used to stage the disease. Surgical resection remains the primary treatment, therefore this study is done to evaluate the surgical outcomes and recurrence rates associated with two surgical approaches: endoscopic medial maxillectomy and lateral rhinotomy with medial maxillectomy.

Methods: A retrospective study was conducted among 40 inverted papilloma patients,surgically treated from June 2014 to May 2023 at a tertiary care hospital. Patients with incomplete medical records, partial resections, or associated malignancies and loss to follow-up were excluded. Tumors were staged using the Krouse staging system. Surgical approaches were categorized as endoscopic medial maxillectomy (EMM) and lateral rhinotomy with medial maxillectomy (LRMM). Data was analyzed using SPSS version 22.0 with chi-square/Fisher’s exact tests and

logistic regression. Kaplan–Meier analysis was used to assess time to recurrence.p value of <0.05 was considered statistically significant.

Results: The mean age was 49.4 ± 3.2 years with a male predominance (67.5%).Most patients presented with unilateral nasal mass and nasal obstruction and the mean symptom duration was 16.5 ± 3 months.55% underwent LRMM and 45% EMM, with more complications noted in the LRMM group.B Hospital stay was significantly (p < 0.001) longer in LRMM (6.2 days) compared to EMM (3.1 days).Recurrence occurred in 17.5% of patients, with no significant difference in recurrence- free survival between the two groups.

Conclusions: EMM is a safe and effective option for early-stage disease,since it is associated with fewer complications, shorter hospital stay, and no functional impairment compared to LRMM. Long-term follow-up is important to monitor recurrence. Both techniques showed similar recurrence rates and recurrence-free survival outcomes